There are many different designs for surgical clip appliers for a variety of surgical procedures including both open and laparoscopic surgery.
This invention comprises improvements in repeating multi-clip appliers of the kind described and claimed in Joseph W Blake III U.S. Pat. Nos. 6,423,079 and 6,869,435, and in U.S. patent application Ser. No. 13/385,760 filed Mar. 6, 2012 entitled Surgical Clip Applier.
U.S. Pat. No. 6,423,079 describes a clip applier with an operating handle and clip applying mechanism performing an operating cycle in which a clip is applied in surgery and the clip applier jaws are reloaded with a single clip from a clip supply channel for clip application in the next cycle. The applier provides a moveable clip supply channel containing a line of clips that are released seriatim.
Clip crimping jaws apply a clip with a rearward movement of a cam member thereby allowing the functions of clip loading and jaw closure to be coordinated and operated by a single sliding bar moving reciprocally to load and fire clips. The clip actuating mechanism includes a combined actuating bar and in-line clip supply channel together with clip indexing mechanisms arranged so that with a squeeze of the operating levers, the actuating bar moves rearward in the appliance to apply a clip in surgery, capture the next in-line clip, index a line of clips rearward away from the clip jaws; and that with release of the operating levers, the jaws open, the next in-line clip is loaded into the jaws, the second next in-line clip is separated from the line, and the clip indexing movement is reset for the next cycle.
U.S. Pat. No. 6,869,435 discloses a repeating multi-clip applier having an operating handle housing cooperating with a removable and disposable clip applying cartridge. The operating handle housing comprises a pistol grip set of handles which provide linear reciprocating motion by means of a spring biased translator slide for actuating the clip applying mechanism within the cartridge. The operating handle housing includes a rotary forefinger wheel hub and rotatable drum subassembly which receive the clip cartridge for 360° rotation about the cartridge axis and which link the cartridge clip applying mechanism to the translator slide.
The operating handle housing further comprises an anti-backup mechanism to prevent a partial pull and release of the operating handles to avoid a well-known hazard that can occur when clip appliers are used in surgery. The hazard is that of dropping and losing a partially closed clip in a surgical site. The anti-backup mechanism avoids the hazard by preventing handle release before a clip in the instrument jaws is fully closed and applied at a surgical site.
The '435 clip applying mechanism includes a combined actuating bar and in-line clip supply cartridge together with clip advancing mechanisms arranged so that with a squeeze of the operating handle, the actuating bar moves rearward in the instrument to close its jaws to apply a clip in surgery, capture the next in-line clip, retain and move a line of clips rearward away from the clip jaws, and that with release of the operating levers, the jaws open, the next in-line clip is loaded into the jaws, the second next in-line clip is separated from the line, and the clip retaining means is reset for the next cycle.
U.S. patent application Ser. No. 13/385,760 filed Mar. 6, 2012 is directed to a surgical clip applier comprising handle and cartridge. The handle is a scissor type having a socket for receiving the cartridge and having levers and links for providing spring biased linear reciprocation motion to the cartridge. The handle further contains an anti-backup mechanism to ensure that handle movement is restricted to full pull and full release strokes. The cartridge has a pull bar for receiving linear reciprocating motion and for transmitting the motion to cartridge components for actuating clip applying jaws and components for supplying surgical clips one at a time to the jaws. For a squeeze and release of the handle, the clip applier applies a clip in surgery, separates the next clip from a stack of clips in a clip magazine, draws the remaining clip stack back from the jaws to keep stack together, draws a clip pusher into position behind the next clip, provides a safety toggle to ensure that jaws open to receive next clip, and advances next clip into the jaws. When the last remaining clip in the clip magazine is used, a lock out mechanism prevents further operation of handle and cartridge mechanisms.
In practice, clip cartridges are ordinarily used a single time and discarded. Operating handles, on the other hand, may be disposed of after use with a single cartridge, or may be used with a plurality of cartridges in a single surgical procedure and then discarded, or may be sterilized after each surgical procedure and used over and over again.